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Anxious and losing sleep...Assessment of Risk?
Dr. Handsfield,
I am gay. I know how to protect myself in sexual encounters. I practice safe sex. I ask my few sex partners their HIV status before doing anything. I think I know what is safe and what is not safe, however, I hooked up with a man a couple weeks ago and it's been bugging me ever since, probably because I don't find myself in this position, so to speak, too often in my life.
We talked before we met. We talked about our mutual HIV status. Neg on both counts. I was tested a couple months ago and I was negative then. I've not done anything to make that different hopefully. He said he was also negative, who knows when his last test was. Safe sex was planned. We performed mutual oral on each other, considered safe. He "rimmed" me. I'm assuming that saliva in the anal area is not considered high risk. At one point he tried to enter me anally with his erection. It did not go far, and a complete insertion did not take place. There was resistance from me and I stopped it.This happened in a matter of less than 60 seconds. It stressed me out. I tend to be an anxious person anyway....so I've been having some sleep disturbance.
I had a rapid HIV test after two weeks....sixteen days. I know, it's way too soon, but it was free and I was there so,....but does the negative result so early mean nothing? Am I overreacting? Could you do the math that I can't seem to do for myself?
Thank you for your input.
I am gay. I know how to protect myself in sexual encounters. I practice safe sex. I ask my few sex partners their HIV status before doing anything. I think I know what is safe and what is not safe, however, I hooked up with a man a couple weeks ago and it's been bugging me ever since, probably because I don't find myself in this position, so to speak, too often in my life.
We talked before we met. We talked about our mutual HIV status. Neg on both counts. I was tested a couple months ago and I was negative then. I've not done anything to make that different hopefully. He said he was also negative, who knows when his last test was. Safe sex was planned. We performed mutual oral on each other, considered safe. He "rimmed" me. I'm assuming that saliva in the anal area is not considered high risk. At one point he tried to enter me anally with his erection. It did not go far, and a complete insertion did not take place. There was resistance from me and I stopped it.This happened in a matter of less than 60 seconds. It stressed me out. I tend to be an anxious person anyway....so I've been having some sleep disturbance.
I had a rapid HIV test after two weeks....sixteen days. I know, it's way too soon, but it was free and I was there so,....but does the negative result so early mean nothing? Am I overreacting? Could you do the math that I can't seem to do for myself?
Thank you for your input.
MEDICAL PROFESSIONAL
This doesn't change my assessment. And even if it did, would it matter? What if I guessed at a ten-fold higher risk, i.e. 1 in 1,000 instead of 1 in 10,000? Then your overall risk rises to 1 in 3 million. That should sound equally good to you as 1 in 30 million!
Take care and stay safe.
Take care and stay safe.
Thank you for your response. It has already helped to settle my fears considerably. 1 in 30 million sounds good to me.
Could I just clarify one point? When I say a complete insertion did not take place...I mean he may have penetrated three quarters of an inch if that, but not intra rectally (I would have known/felt that), in that very brief period. No ejaculation, no detectable pre-ejaculate. Does this change the numbers or your opinion? Thanks again and I won't beat the horse after this.
W.
Could I just clarify one point? When I say a complete insertion did not take place...I mean he may have penetrated three quarters of an inch if that, but not intra rectally (I would have known/felt that), in that very brief period. No ejaculation, no detectable pre-ejaculate. Does this change the numbers or your opinion? Thanks again and I won't beat the horse after this.
W.
MEDICAL PROFESSIONAL
The reliability of test results at various intervals and how this relates to the level of risk of the exposure have been discussed innumerable times and I'm not going to repeat it here. Use the search link and enter "seroconversion window" or "time to positive HIV test".
Is a 6 week negative antibody test after oral sex with a possible HIV partner sufficient?
how sufficient do you think it is?
how sufficient do you think it is?
MEDICAL PROFESSIONAL
Welcome to the forum.
Cngratulations for your understanding of, and adherence to, safe sex standards. It seems you follow them more carefully than many men who have sex with men. If you continue to do so, and if all your sexual exposures are similar to those described here, you can expect to go your entire life without catching HIV and probably no other STD.
That said, it is conceivable there was some miniscule risk of transmission of HIV from the brief non-penetrative contact between his penis and your anus. Rimming is no known risk. However, that probably was close to zero risk, even if your partner had HIV. And based on your description, it is very unlikely your partner had HIV.
Therefore, from a risk assessment perspective, you didn't need HIV testing after this event; the only reason for it is the reassurance you will feel once your test is definitively negative. You are correct that 2 weeks is too soon for antibody testing. Probably around one third of newly infected people would have positive results by then, so the negative result is somewhat reassuring. If you remain anxious about it, have another test about 6 weeks after the event.
The numerical estimate you request is pretty meaningless, because I can only guess at the parameters. But if we assume 1 chance in 1,000 that your partner had HIV and 1 chance in 10,000 the virus could have been transmitted by this exposure, then the chance you caught HIV comes to 1 in 10 million. The negative test at 2 weeks reduces this to around 1 in 30 million. That's zero risk for practical purposes.
Bottom line: If these numbers don't completely settle your fears, have another HIV test at 6 weeks. But in the meantime, don't worry about it. You're fine.
Regards-- HHH, MD
Regards-- HHH, MD
Cngratulations for your understanding of, and adherence to, safe sex standards. It seems you follow them more carefully than many men who have sex with men. If you continue to do so, and if all your sexual exposures are similar to those described here, you can expect to go your entire life without catching HIV and probably no other STD.
That said, it is conceivable there was some miniscule risk of transmission of HIV from the brief non-penetrative contact between his penis and your anus. Rimming is no known risk. However, that probably was close to zero risk, even if your partner had HIV. And based on your description, it is very unlikely your partner had HIV.
Therefore, from a risk assessment perspective, you didn't need HIV testing after this event; the only reason for it is the reassurance you will feel once your test is definitively negative. You are correct that 2 weeks is too soon for antibody testing. Probably around one third of newly infected people would have positive results by then, so the negative result is somewhat reassuring. If you remain anxious about it, have another test about 6 weeks after the event.
The numerical estimate you request is pretty meaningless, because I can only guess at the parameters. But if we assume 1 chance in 1,000 that your partner had HIV and 1 chance in 10,000 the virus could have been transmitted by this exposure, then the chance you caught HIV comes to 1 in 10 million. The negative test at 2 weeks reduces this to around 1 in 30 million. That's zero risk for practical purposes.
Bottom line: If these numbers don't completely settle your fears, have another HIV test at 6 weeks. But in the meantime, don't worry about it. You're fine.
Regards-- HHH, MD
Regards-- HHH, MD
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